title: Reversible ureteral obstruction due to polyomavirus infection after percutaneous nephrostomy catheter placement.
abstract: BK virus (BKV) is a human polyomavirus that remains latent in the urinary tract epithelium in most individuals. However, in immunocompromised states, including after hematopoietic stem cell transplantation (HSCT), BKV may reactivate and cause infection predominantly affecting the bladder, commonly manifested as hemorrhagic cystitis. Renal insufficiency, occasionally requiring hemodialysis, is not uncommon and was previously attributed to medications or the development of tubulointestitial nephritis. We report a series of 6 HSCT recipients who developed obstructive uropathy of the upper urinary tract system secondary to inflammation and hemorrhage involving the upper uroepithelium, causing ureteral stenosis. Temporary placement of a percutaneous nephrostomy catheter relieved the obstruction and significantly improved kidney function, successfully preventing progression to more advanced renal disease in these patients.
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA.
authors.forename: Hassan
authors.initials: H
authors.lastname: Khan
authors.forename: Shilpa
authors.initials: S
authors.lastname: Oberoi
authors.forename: Armeen
authors.initials: A
authors.lastname: Mahvash
authors.forename: Manish
authors.initials: M
authors.lastname: Sharma
authors.forename: Gabriela
authors.initials: G
authors.lastname: Rondon
authors.forename: Amin
authors.initials: A
authors.lastname: Alousi
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Shpall
authors.forename: Dimitrios P
authors.initials: DP
authors.lastname: Kontoyiannis
authors.forename: Richard E
authors.initials: RE
authors.lastname: Champlin
authors.forename: Stefan O
authors.initials: SO
authors.lastname: Ciurea
mesh_terms: D001739:BK Virus; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D009403:Nephrostomy, Percutaneous; D027601:Polyomavirus Infections / Q000628:therapy* / Q000821:virology; D014184:Transplantation, Homologous; D014517:Ureteral Obstruction / Q000628:therapy* / Q000821:virology; D014546:Urinary Catheterization